冻干重组人脑利钠肽对心肌缺血患者氧化应激水平、炎症指标和疗效评估

Evaluation on the Levels of Oxidative Stress,Inflammatory Indices and Efficacy of Lyophilized Recombinant Human Brain Natriuretic Peptide in Patients with Myocardial Ischemia

目的:探讨冻干重组人脑利钠肽治疗心肌缺血及对患者炎症指标、氧化应激指标的影响。方法:选取2016年4月-2017年4月本院收治的心肌缺血患者124例。按照用药方案不同分为对照组61例和试验组63例。对照组单纯采用曲美他嗪治疗,试验组在对照组基础上加用冻干重组人脑利钠肽治疗。比较两组治疗前后的血清丙二醛(malondialdehyde,MDA)、活性氧(reactive oxygen species,ROS)、超氧化物歧化酶(superoxide oxygen dismutase,SOD)、总抗氧化能力(total antioxidant capacity,T-AOC)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)等氧化应激指标;血浆纤维蛋白原(fibrinogen,Fg)、单核细胞趋化因子-1(monocyte chemotactic protein 1,MCP-1)、高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、N末端B型利钠肽前体(N-terminal pronatriuretic peptide,NT-pro BNP)及白介素-6(interleukin-6,IL-6)等炎症指标及临床疗效。结果:治疗2、6个月后,两组MDA、ROS、T-AOC、水平均低于治疗前,GSH-Px、SOD均高于治疗前,且试验组MDA、ROS、T-AOC水平均低于对照组,GSH-Px、SOD均高于对照组,比较差异均有统计学意义(P<0.05);治疗2、6个月后,两组NT-pro BNP、IL-6、Fg、MCP-1、hs-CRP均低于治疗前,且试验组均低于对照组,比较差异均有统计学意义(P<0.05);试验组总有效率为93.65%,高于对照组的81.97%(X^2=3.979,P=0.046)。结论:冻干重组人脑利钠肽辅助曲美他嗪治疗心肌缺血患者的临床效果良好,能有效改善患者氧化应激指标,调节炎症指标,值得推广。

Objective:To investigate the effect of Lyophilized Recombinant Human Brain Natriuretic Peptide in treatment of myocardial ischemia and the index of inflammation and oxidative stress.Method:A total of 124 patients with myocardial ischemia from April 2016 to April 2017 in our hospital were selected,according to different drug regimen,they were divided into 61 cases of control group and 63 cases of experimental group.The control group was treated with Trimetazidine,and experimental group was treated with Lyophilized Recombinant Human Brain Natriuretic Peptide on the basis of control group.The oxidative stress indicators such as malondialdehyde(MDA),reactive oxygen species(ROS),superoxide oxygen dismutase(SOD),total antioxidant capacity(T-AOC),glutathione peroxidase(GSH-Px),and inflammatory markers such as fibrinogen(Fg),monocyte chemotactic protein 1(MCP-1),hypersensitive C-reactive protein(hs-CRP),N-terminal pronatriuretic peptide(NT-proBNP),interleukin-6(IL-6)before and after treatment and clinical effects between two groups were compared.Result:After treatment 2 and 6 months,the levels of MDA,ROS,T-AOC in two groups were lower than those before treatment,the levels of GSH-Px and SOD were higher than those before treatment,and the levels of MDA,ROS and T-AOC in experimental group were all lower than those of control group,GSH-Px and SOD were all higher than those of control group,the differences were statistically significant(P<0.05).After treatment 2 and 6 months,the levels of NT-proBNP,IL-6,Fg,MCP-1,hs-CRP in two groups were all lower than those before treatment,and experimental group were all lower than those of control group,the differences were statistically significant(P<0.05).The total effective rate of experimental group was 93.65%,which was higher than 81.97%of control group(x2=3.979,P=0.046).Conclusion:Lyophilized Recombinant Human Brain Natriuretic Peptide assisted Trimetazidine in treatment of myocardial ischemia patients has a good clinical efficacy,can effectively improve the index of oxidative stress,adjust the inflammatory index,which is worth popularizing.